Ticket for Outdoor Patient
| Ward No. 12 | U-PHC No. | Registration No. 00407 | Date 30/08/2018 |
| Token No | SM/18-19/2611 26/02/2019 | Serial | 023 |
| Patient Name | Mrs. SANTI BISWAL | Contact No | 8100218312 |
| Address | DR N.L BHATTACHARYA ST | Age | 47 Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||